Individual provider Active NPI

Michaela Ermanie Herbert

  • Family Nurse Practitioner
  • Grapevine, TX
National Provider Identifier
1902305246
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP136409 Issued in TX
Practice address
837 E Walnut St
Grapevine, TX 76051-6134
Phone
(817) 305-4681
Fax
(817) 442-0748
NPI assigned
Feb 1, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP136409 TX Primary
Primary Care Nurse Practitioner 363LP2300X 935323 TX

Addresses

Primary practice location

837 E Walnut St
Grapevine, TX 76051-6134

Mailing address

7720 Greengage Dr
Fort Worth, TX 76133-7914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180417001754 TX Practitioner - Nurse Practitioner 0547523904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP136409TXMDFamily Nurse Practitioner
935323TXMDPrimary Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: mherbert304638@direct.phhs.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1902305246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7720 GREENGAGE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761337914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 E WALNUT ST",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760516134",
            "telephone_number": "817-305-4681",
            "fax_number": "817-442-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBERT",
        "first_name": "MICHAELA",
        "middle_name": "ERMANIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136409",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "935323",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

Verify at the official NPI Registry.